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Search Results: 1 - 10 of 1898 matches for " Rheumatoid arthritis "
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A Focus on the Diagnosis of Early Rheumatoid Arthritis  [PDF]
Marta Olivieri, Maria Chiara Gerardi, Francesca Romana Spinelli, Manuela Di Franco
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.37116
Abstract:

Nowadays it is worldwide accepted that early diagnosis and early treatment of Rheumatoid Arthritis (RA) can improve the prognosis in most of patients. In this way, the 2010 ACR/EULAR Rheumatoid Arthritis classification criteria have shown to be more sensitive than the ACR 1987 criteria and include better patients with early RA. Other important point to focus on is to identify predictive factors for outcome, in order to propose a more aggressive treatment for early RA patients who could develop a persistent and/or erosive disease. The presence of Rheumatoid Factors (RF) and Anti- citrullinated peptides antibobies (ACPA), as well as the duration of the disease at the time of diagnosis, are independent risk factors for the development of erosive RA. As for imaging, both traditional X-ray and Magnetic Resonance Imaging (MRI) highlight respectively the Rapid Radiological Progression (RRP) and the presence of bone edema which are associated to a more aggressive disease. In the last years, the musculoskeletal ultrasonography (MSUS) has emerged as a useful imaging technique since it allows to identify synovitis and bone alteration earlier than the radiological examination. Interating clinical, serological and imaging data the clinician can define the effective disease activity of each patient.

Prednisone on the threshold of rational use in the treatment of rheumatoid arthritis  [PDF]
Doyt L. Conn
Health (Health) , 2013, DOI: 10.4236/health.2013.58A1001
Abstract:

This is a review of the evolution of the use prednisone in the treatment of rheumatoid arthritis (RA). Cortisone was introduced in 1949 and shortly thereafter, the Mayo investigators found that low divided doses with slow tapering were effective and caused fewer side effects. In 1959, a British double blind 2 year study of prednisolone treatment in early RA demonstrated effectiveness and reduced bony erosions. This experience was lost over time and empiricism and efforts to reduce side effects dominated practice for the next 35 years. Since 1995, a number of controlled studies of low single daily doses of prednisone in early RA have been reported by European investigators. They have shown clinical improvement, reduced bony erosions, augmentation of the effect of dmards and few side effects. During the last 25 years, the molecular actions of glucocorticoids have been elucidated. The time relationship of the dose to the biologic and clinical effects has been established. As a result of the information on the diurnal effect of glucocorticoids and the documentation of the effect occurring 5-6 hours after the dose and dissipating by 24 hours, a delayed release preparation of prednisone has been developed. With the rediscovery of the effectiveness of low single daily morning dose of prednisone in early RA by controlled studies and the demonstration of the onset and duration of the clinical effect of low dose of prednisone, it is now possible to use low doses of prednisone rationally and effectively in the treatment of RA. It remains to be determined whether a single morning, single evening or a twice a day low dose is the most effective and safe. It is doubtful if the new delayed release prednisone is any more effective than the usual immediate release prednisone if given at the same time.

A Study on the Pulmonary Manifestations of Rheumatoid Arthritis from a North Indian Town  [PDF]
Nazish Fatima, Mohammed Shameem, Abida Malik, Parvez Anwar Khan, Fatima Shujatullah, Sohail Ahmed, Nabeela  
Open Journal of Respiratory Diseases (OJRD) , 2013, DOI: 10.4236/ojrd.2013.33020
Abstract:

Rheumatoid arthritis (RA) is a chronic systemic disease of unknown etiology characterized by articular involvement, extra-articular involvement, and the presence of serum rheumatoid factor. Pulmonary involvement in RA is a common extra-articular manifestation of rheumatoid arthritis (RA) that confers significant morbidity and mortality. We undertook this study to determine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) from a North Indian town. 62 patients who met the American College of Rheumatology (formerly the American Rheumatism Association) 1987 classification criteria for RA were subjected to clinical examination of chest, X-Ray-chest (CXR), pulmonary function tests (PFT) and high resonance computed tomography (HRCT). 40.3% patients had some pulmonary symptoms with exertional dyspnoea in 21%, cough with expectoration in 17.7%, fine respiratory rales in 11.3%, patients X-ray chest bilateral lower zone haziness in 16% and prominent pulmonary vasculature in 3.2%. 43% had abnormal PFT-restrictive pattern in 29%, obstructive pattern 8% and mixed pattern in 6.4%. HRCT revealed abnormal findings in 33.8% commonest being ground glass pattern in both lower lobes 19.3%, sub pleural reticulations in 9.6%, pleural thickening in 3.2% and pulmonary vascular prominence in 1.6%. To provide optimal treatment, physicians must always consider the possibility of associated pulmonary manifestations when patients with RA are evaluated.

Rheumatoid Arthritis of Man: A Study of 35 Cases in a Senegalese Hospital  [PDF]
Souhaibou Ndongo, Abdoulaye Pouye, Lionel Ouedraogo, Emeric Azankpan, Ngoné Diack, Thérèse Moreira Diop
Open Journal of Internal Medicine (OJIM) , 2014, DOI: 10.4236/ojim.2014.44021
Abstract: Background: Rheumatoid arthritis is predominant in women. In men certain clinical signs can delay diagnosis. Methods: A cross-section study of the epidemio-clinical and immunobiological features of rheumatoid arthritis in a male, black African population was carried out at the Aristide Le Dantec, University hospital of Dakar. Results: we studied 35 male subjects with rheumatoid arthritis. Their mean age was 42 years and the average time between the onset of symptoms to diagnosis was 44 months. In 70% of these patients, at least one joint deformation was present, most frequently an ulnar deviation of the fingers (34.3%). Extra-articular symptoms were dominated by dry eye syndrome (34%) and anemia (17%). Anemia was significantly less frequent in men than in women. The erythrocyte sedimentation rate was accelerated in 51.4% and C reactive proteins were increased in 92% of patients. The rheumatoid factor was positive in all patients and the anticyclic Citrullinated Peptide (CCP) antibody was positive in 80% of cases. Conclusion: Male rheumatoid arthritis, relatively less studied, was associated with strongly positive immunological markers and a high rate of joint disorders.
Rheumatoid Factor and Anti Citrulinated Peptide. Relation with Remission and Progression in Rheumatoid Arthritis with Biologic Agent Therapy, during a One-Year Follow-Up  [PDF]
Asunción Acosta Pereira, Berta Magallares López, Esther Moga Naranjo, Arturo Rodríguez de la Serna
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2014, DOI: 10.4236/ojra.2014.41005
Abstract: The aim of this study is to assess the variations of the RF and ACCP in RA patients treated with biologics in actual clinical practice (real) conditions for a one-year follow-up from the first biologic medication. The evaluated patients with a diagnosis of RA, according to the American College of Rheumatology (ACR) 1987 were selected from the outpatient consult of Rheumatology of the “Hospital de Sant Pau” during one month (November 2012). We collected and analyzed data from 41 patients with RA and positivity for RF and/or ACCP. Of the 41 patients had given FR and ACCP at 3, 6 and 12 months respectively in 18 and 10 patients. In 22 patients had given DAS 28 at 3, 6 and 12 months respectively. The mean age of the sample is 55 years (range 29-79), with a mean disease progression 9 years (4 months to 32 years). 70% are women. 33 patients (80.5%) initiated treatment with anti-TNF and 8 (19.5%) with other no anti-TNF mechanism of action. There was a statistically significant (p = 0.001, ANOVA) decrease in DAS 28 (average decrease of 1.6 points) at 3 months is maintained at 6 and 12 m and no significant differences in their evolution by separating anti-TNF drugs vs. other biological agents (different mechanisms of action (p = 0.285). So we have not detected a correlation between DAS 28 and FR or ACCP along the first 12 months of biological treatment. In our experience we did not find a correlation between DAS 28 and RF or ACCP, thus RF and ACCP do not appear to predict the response to treatment.
Unusual Presenting Syndrome of Rheumatoid Arthritis Exacerbation  [PDF]
Tatiana Reitblat, Olga Reitblat, Ori Elkayam
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2012, DOI: 10.4236/ojra.2012.21001
Abstract: We herewith report the rare case of a patient with juvenile rheumatoid arthritis who developed on 2 occasions the clinical picture of an isolated unilateral palsy of the inferior oblique muscle—Brown’s syndrome, following pregnancies, each time in a different eye. Although the eye is frequently involved in rheumatoid arthritis (RA), the Brown’s syndrome is seldom reported in literature with regards to RA.
Open-Label, Pilot Study of the Safety and Clinical Effects of Rituximab in Patients with Rheumatoid Arthritis-Associated Interstitial Pneumonia  [PDF]
Eric L. Matteson, Tim Bongartz, Jay H. Ryu, Cynthia S. Crowson, Thomas E. Hartman, Paul F. Dellaripa
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2012, DOI: 10.4236/ojra.2012.23011
Abstract: Objective: To investigate the clinical effect of rituximab (RTX) in the management of progressive rheumatoid arthritis related interstitial lung disease (RA-ILD). Methods: A total of 10 patients with progressive RA-ILD were enrolled into this 48-week, open-label treatment study. Treatment was with RTX at 1000 mg at day 1, day 15, and again at weeks 24 and 26, with concomitant methotrexate therapy. Results: The study included 4 men and 6 women. Of 7 evaluable patients at week 48, the diffusing capacity to carbon monoxide had worsened by at least 15% in 1 patient, was stable in 4 patients, and increased by >15% of baseline value in 2 patients. The forced vital capacity declined by at least 10% in 1 patient, was stable in 4 patients, and increased by at least 10% in 2 patients. High resolution computed tomo-graphy of the chest showed improvement in 1 patient, and was unchanged in 5. Three patients were withdrawn, one who had an infusion reaction at week 0, one at week 5 who was hospitalized for congestive heart failure at week 5 and who later died at week 32 of complications following a traumatic hip fracture, and one died at week 6 of possible pneumonia. Conclusions: In this pilot study of 10 patients with RA-ILD treated with RTX, measures of lung disease remained stable in the majority of study completers. Further research is needed to clarify whether this treatment has a role in management of RA-ILD.
Disability Work among Argentinean Patients with Rheumatoid Arthritis  [PDF]
Tamborenea Maria Natalia, Silvia Moyano Caturelli, Jackeline Spengler, Grisel Olivera Roulet
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2012, DOI: 10.4236/ojra.2012.23014
Abstract: Objective: 1) To analyze the prevalence of Work Disability (WD) in RA Argentinian patients who are attending at the National Rehabilitation Service (NRS); 2) To measure general, socioeconomics and disease characteristics in this population; 3) To characterize the associated factors of work disability in this group. Methods: Design: cross section observational study. RA patients attending the NRS were included in consecutive form. Clinical, demographic and ra-diological data were collected. All patients answered about their employment status. WD was defined if the work status was unemployed due to RA, retirement prior to the normal age, or disabled pension. Comparing analysis among pa-tients with and without paid work was done. Housewives, retired patients and students were excluded from the compar-ing analysis. Results: Three hundred and eleven patients were included (n = 311). The prevalence of WD was 44.05% (n = 137). During the study eighty 5 (27.3%) patients were in paid employment, 48 (15.3%) were retired, 39 (12.5%) were housewives, and 2 (0.6%) patients were students. Factor associated to WD were female sex, more than 5 years of disease duration, have health insurance, education beyond high school, and greater functional limitation : HAQ > 1 and function class 3 - 4. In the multivariable logistic regression model female sex was a significant and independent predictor of WD. Have health insurance; and more than high school education were protector factors of WD in this model. Conclusion: WD prevalence in this sample was higher than other countries. Socioeconomics factors more than diseases factors were significant predictors of productivity loss in this sample.
Remission of arthritis but persistent cutaneous lesions following tocilizumab treatment in a RA-patient suffering from concomitant psoriasis  [PDF]
Wolfgang Hartung, Boris Ehrenstein, Rotraud Wallisch, Martin Fleck
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.21018
Abstract:
Modulation of the interleukin-6 pathway with tocilizumab has been demonstrated to be highly effective in substantial numbers of patients suffering from rheumatoid arthritis (RA), and juvenile idiopathic arthritis. A pivotal role of the IL-6 pathway has been also established in other autoimmune conditions including psoriasis and psoriatic arthritis, becoming attractive targets for therapeutic IL-6 inhibition. Here, we describe the first case of tocilizumab treatment in a RA-patient suffering from concomitant severe psoriasis, who achieved remission of RA, whereas no improvement of psoriatic lesions could be observed.
Atypical Femoral Fractures in a Patient with Continuous Decreasing BMD after Only 1.5 Years of Bisphosphonate Treatment  [PDF]
Chia-Jung Hu, Jenn-Huei Renn, Shan-Wei Yang, Kai-Cheng Lin
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2014, DOI: 10.4236/ojra.2014.41004
Abstract: Objective: Bisphosphonates were accepted first line treatment for osteoporosis. Long-term bisphosphonate treatment has been reported to be complicated with osteonecrosis of jaw (ONJ) and atypical fracture of femur. It is proposed to be the result of impaired remodeling of minor injury of bone. An atypical fracture occurs on a patient received only 1.5 years of bisphosphonate treatment with continuous decreasing bone mineral density. Case Presentation: This is a 53-year-old female Taiwanese. She has rheumatoid arthritis and has received long-term glucocorticoid treatment. Continuous decrease of bone mineral density in the serial BMD examination after alendronate treatment can be found. Thigh pain occurs after only 1.5 years of bisphosphonate treatment and it progresses to atypical fracture. Conclusions: Atypical fracture can occur in patients receive only short-term bisphosphonate treatment even BMD is still decreased after bisphosphonate treatment. Autoimmune disease, glucocorticoid treatment, Asian and female may be the possible risk factors.
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